Thiamine and Acute Decompensated Heart Failure: Pilot Study
Status:
Completed
Trial end date:
2012-06-01
Target enrollment:
Participant gender:
Summary
Heart failure remains an increasing cause of morbidity and mortality in the United States
even in the face of recent advances in the treatment of cardiovascular disease. There is an
urgent need to reevaluate the treatment of heart failure. Shifting substrate utilization used
in energy metabolism from fatty acids to glucose is beneficial to the heart presumably by
increasing the efficiency of ATP production. Several new drugs for the treatment of cardiac
ischemia work by this mechanism. There is increasing evidence that patients with heart
failure may also benefit by the same type of intervention. Patients with heart failure are
known to have low serum thiamine levels because of poor dietary intake and increased urinary
excretion. Inadequate thiamine will deleteriously shift substrate utilization from glucose to
fatty acids.
We hypothesize that thiamine supplementation will be beneficial for patients with heart
failure by increasing glucose and decreasing fatty acid utilization. This will be initially
tested in a pilot double-blinded placebo controlled study of thiamine supplementation in
diabetic and non-diabetic patients presenting to the emergency department with acute
decompensated heart failure.